Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 00018 | Date 06/09/2019 |
| Token No | SM/19-20/2231 14/02/2020 | Serial | 016 |
| Patient Name | Mrs. SUDAMA MALLICK | Contact No | 8961671771 |
| Address | B/92/X TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 77 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||